A survey of health care providers and community leaders in Nebraska and six other states focused on the state of health care in rural America — and strategies to improve it.

Heidi Schultz, a rural health care program officer with the Bipartisan Policy Center, says there are renewed efforts to revive rural America, but its residents continue to face greater disparities and barriers to quality health care than their urban counterparts.

“What we hear the most is just concern for being able to provide the kind of health care that each community needs,” Schultz says. “These health care providers really want to do the right thing for their patients but a lot of times their hands are tied by either reimbursement mechanisms or regulations.”

A federal report finds 46-million Americans living in rural areas are at a greater risk of dying from heart disease, cancer, chronic lower respiratory disease, and stroke than city dwellers.

Schultz says rural residents also have higher rates of obesity, tobacco and opioid use, and suicide than in urban areas.

“A lot of times, it’s access to health care, it’s distance to health care and it’s our population,” Schultz says. “Our population in rural (areas) tends to be older, we have a lot of obesity and we do have a lot of people living in poverty, so there are quite a few reasons those statistics exist.”

According to the report, some of the main health care issues rural residents are struggling with include heart trouble, COPD and lung problems, and a high rate of type two diabetes.

Schultz says, “We also have a lower number of mental health providers and we heard a lot in these roundtables and interviews, concern for people with mental health issues and concern for the providers that want to help them but maybe don’t have the tools they need or a place to refer them to.”

One recommendation is to “rightsize” health care services to fit community needs, recognizing that every rural area is different and has different needs.

“It doesn’t necessarily mean that every community needs a hospital with in-patient beds,” she says. “What we see in a lot of rural communities is the need for clinics, out-patient services, specialty care, therapies following a stroke or a severe illness.”

The report, “Reinventing Rural Health Care: A Case Study of Seven Upper Midwest States,” was created in collaboration with the Center for Outcomes Research and Education (CORE).

In addition to Nebraska, the surveys were also conducted in Iowa, Minnesota, Montana, North Dakota, South Dakota, and Wyoming. See the full report at: bipartisanpolicy.org.